<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="utf-8">
    <title>{REPORT_TITLE}</title>
    <link rel="stylesheet" href="http://localhost:53618/Content/css/reporting.css?v=1,32." type="text/css" media="screen" />
</head>
<body>
    <div class="container-fluid">
        <div class="row-fluid">
            <div class="span9">
                <h2 class="central">
                    Order Request</h2>
                <br />
                <table class="goods-detail" align="center" cellspacing="0" cellpadding="0" border="1">
                    <tr>
                        <th align="left">
                            Order Request No
                        </th>
                        <th align="left">
                            Date
                        </th>
                        <th align="left">
                            Currency
                        </th>
                    </tr>
                    <tr>
                        <td align="center">
                            OR/DRC/UG/00015
                        </td>
                        <td align="center">
                            10/12/2012
                        </td>
                        <td align="center">
                            UGX
                        </td>
                    </tr>
                    <tr>
                        <th align="left">
                            Project
                        </th>
                        <th align="left">
                            Project No
                        </th>
                        <th align="left">
                            Donor
                        </th>
                    </tr>
                    <tr>
                        <td align="center">
                            Poverty Eradication in Uganda ONCE AND FOR ALL
                        </td>
                        <td align="center">
                            509-UG-PE
                        </td>
                        <td align="center">
                            DN
                        </td>
                    </tr>
                    <tr>
                        <th align="left">
                            Requested Delivery Date
                        </th>
                        <th align="left">
                            Requested Delivery Destination
                        </th>
                        <th align="left">
                            Final Delivery Destination
                        </th>
                    </tr>
                    <tr>
                        <td align="center">
                            31/10/2012
                        </td>
                        <td align="center">
                            Kampala
                        </td>
                        <td align="center">
                            Gulu
                        </td>
                    </tr>
                </table>
                <br />
            </div>
            <div class="span3">
                <table>
                    <tbody>
                        <tr>
                            <td>
                                <img src="http://localhost:53618/Content/images/reports/drc.png" alt="" />
                            </td>
                        </tr>
                        <tr>
                            <td>
                                <img src="http://localhost:53618/Content/images/reports/ddg.png" alt="" />
                            </td>
                        </tr>
                        <tr>
                            <td>
                                DANISH REFUGEE COUNCIL<br />
                                {LABEL_BORGERGADE10}<br />
                                {LABEL_DK1300}<br />
                                {LABEL_DENMARK}<br />
                            </td>
                        </tr>
                        <tr>
                            <td style="padding-top: 5px;">
                                {LABEL_COUNTRY_OFFICE_UGANDA}<br />
                                4688 Kalungi Road<br />
                                Muyenga, Kampala<br />
                            </td>
                        </tr>
                        <tr>
                            <td>
                                <a href="http://WWW.drc.dk">WWW.drc.dk</a><br />
                                <a href="http://WWW.danishdemininggroup.dk">www.danishdemininggroup.dk</a>
                            </td>
                        </tr>
                    </tbody>
                </table>
            </div>
        </div>
        <div class="row-fluid">
            <div class="span12">
                <p>
                    Specification/Description, Unit, Quantities, Estimated Prices & PN/BL.</p>
                <table align="center" cellspacing="0" cellpadding="0" border="1" class="goods-detail">
                    <thead>
                        <tr>
                            <th style="width: 5%; text-align: center;">
                                No
                            </th>
                            <th style="width: 15%;">
                                Item
                            </th>
                            <th style="width: 20%;">
                                Description
                            </th>
                            <th style="width: 10%; text-align: center;">
                                Unit
                            </th>
                            <th style="width: 5%; text-align: center;">
                                Qty
                            </th>
                            <th style="width: 10%;">
                                Est. Unit Price
                            </th>
                            <th style="width: 10%;">
                                Est. Total Price
                            </th>
                            <th style="width: 10%;">
                                PN
                            </th>
                            <th style="width: 5%; text-align: center;">
                                BL
                            </th>
                            <th style="width: 10%;">
                                Remarks
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr ><td align="center">1</td><td>Ferterlisers</td><td>aadsfads</td><td>Pieces</td><td align="center">9</td><td align="right">90.00</td><td align="right">810.00</td><td align="center">509-UG-PE</td><td align="center">1.1</td><td>asdfaa</td></tr><tr ><td align="center">2</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">3</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">4</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">5</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">6</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">7</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">8</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">9</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">10</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">11</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">12</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">13</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">14</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">15</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">16</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr><tr ><td align="center">17</td><td></td><td></td><td></td><td align="center"></td><td align="right"></td><td align="right"></td><td align="center"></td><td align="center"></td><td></td></tr></tbody>
                    <tfoot>
                        <tr>
                            <th colspan="3" align="right">
                                Currency of Order Request &nbsp;
                            </th>
                            <td align="center">
                                UGX
                            </td>
                            <th colspan="2" align="right">
                                Total &nbsp;
                            </th>
                            <td align="right">
                                <b>810.00</b>
                            </td>
                            <th colspan="3">
                                &nbsp;OR Value
                            </th>
                        </tr>
                        <tr>
                            <th colspan="3" align="right">
                                Master Budget Currency &nbsp;
                            </th>
                            <td align="center">
                                USD
                            </td>
                            <th colspan="2" align="right">
                                Total &nbsp;
                            </th>
                            <td align="right">
                                <b>0.32</b>
                            </td>
                            <th colspan="3" class="gridheader">
                                &nbsp;OR Value
                            </th>
                        </tr>
                        <tr>
                            <td colspan="10" rowspan="3" align="left" valign="top">
                                <b>Additional Remarks:</b><br />
                                
                            </td>
                        </tr>
                        <tr>
                        </tr>
                        <tr>
                        </tr>
                    </tfoot>
                </table>
            </div>
        </div>
        <div class="row-fluid">
            <div class="span12">
                <table align="center" cellspacing="0" cellpadding="0" border="1" class="goods-detail">
                    <thead>
                        <tr class="gridheader">
                            <th width="16%">
                                Authorization
                            </th>
                            <th width="21%">
                                Requestor
                            </th>
                            <th width="21%">
                                Approved By
                            </th>
                            <th width="21%">
                                Finance Review of BL/PN
                            </th>
                            <th width="21%">
                                Authorized by Manager/CD
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr><th>Name:</th><td>Frank Nkuyahaga</td><td>Frank Nkuyahaga</td><td>Frank Nkuyahaga</td><td>Frank Nkuyahaga</td><tr><tr><th>Title:</th><td>Finance Manager</td><td>Finance Manager</td><td>Finance Manager</td><td>Finance Manager</td><tr><tr><th>Date:</th><td>12/10/2012 8:19 PM</td><td>22/10/2012 3:44 PM</td><td>14/02/2013 7:56 PM</td><td>14/02/2013 7:57 PM</td><tr><tr><th>Signature:</th><td><img src="" alt="" style="max-width: 100px;" /></td><td><img src="" alt="" style="max-width: 100px;" /></td><td><img src="" alt="" style="max-width: 100px;" /></td><td><img src="" alt="" style="max-width: 100px;" /></td><tr></tbody>
                </table>
            </div>
        </div>
    </div>
</body>
</html>
